Assisted Dying

[mikeg]

I notice there's been a lot of press coverage around the assisted dying bill. To me, it still seems a bit too nanny state and will force those with more than six months to live longer in agony. What about those for whom life is unbearable but not terminal? Surely they have even longer to suffer and should thus on the basis of simple utilitarian ethics take priority over those with less than six months to live? To me that's the wrong way around. I know this may be personal for some on here, many on here are rail staff and have suffered themselves first hand from the way our society doesn't allow those who don't want to live any more a dignified way out. I honestly believe the majority of 'safeguards' should be dropped in the interest of those suffering and the public at large. What are your views?

 

[32475]

I’m for it wholeheartedly for those who are suffering and don’t need to suffer cruelly and needlessly any longer. We have no hesitation in putting down a beloved pet when its quality of life comes into question so why should us humans be any different? So long as I have the mental capacity and the understanding of my family when I’m much older I would have no hesitation in choosing this exit route if I had to.

 

[DarloRich]

why should us humans be any different?

because Humans are higher life form. Your dog is not your equal.

way our society doesn't allow those who don't want to live any more a dignified way out. I honestly believe the majority of 'safeguards' should be dropped in the interest of those suffering and the public at large. What are your views?

I think there is a difference between those who have an incurable, terminal illness and are in terrible pain and those who are fit and well and just think that everything is black and that life is meaningless.

There should be much better treatment for those with, say, mental illness before we get to the dignitas booth!

 

[bleeder4]

Having had to spend 5 days last year going to hospital with my Mum to watch Dad slowly starve to death, I am fervently in favour of assisted dying. We were both practically on our knees begging the staff for him to be given a lethal injection, but the only option was just to give permission for them to stop intravenous injection of food and wait for nature to take its cause. 5 days he lasted and although he was sedated and unaware for the whole time, it was horrific for me and my Mum. We will both bear the emotional toll of that experience for the rest of our lives. If it was a pet it would have been put down in a heartbeat.

 

[dangie]

…So long as I have the mental capacity and the understanding of my family when I’m much older I would have no hesitation in choosing this exit route if I had to.

That is easy to say when you are young, fit & healthy, but maybe not so when that time comes to actually commit yourself to death. I’m saying this as someone who really doesn’t know which side of the fence I’m standing.

 

[Harpo]

Having had to spend 5 days last year going to hospital with my Mum to watch Dad slowly starve to death, I am fervently in favour of assisted dying. We were both practically on our knees begging the staff for him to be given a lethal injection, but the only option was just to give permission for them to stop intravenous injection of food and wait for nature to take its cause. 5 days he lasted and although he was sedated and unaware for the whole time, it was horrific for me and my Mum. We will both bear the emotional toll of that experience for the rest of our lives. If it was a pet it would have been put down in a heartbeat.

As someone who similarly watched both parents' lives end at whatever pace their cancers dictated, I share your pain and your views on an entitlement to a far better death.

I suspect that many would castigate us if we left a pet to die in the manner still deemed fit for humans.

 

[brad465]

I do think there should be a case-by-case basis to assisted dying rather than a blanket time left to live requirement. Dementia patients can experience this for years with all sorts of mental, physical and financial burdens attached, not just to themselves but all their friends and family. But at 6 months left to live (if that's determinable in dementia sufferers), consent is bound to be impossible and almost all the damage/cost has been done anyway. I know if ever ever end up with dementia I'd want the option while I can make it on my own conscience, even if I'd still be around for years after diagnosis.

 

[bahnause]

I think there is a difference between those who have an incurable, terminal illness and are in terrible pain and those who are fit and well and just think that everything is black and that life is meaningless.

This is certainly a perception of mental illness from 50 years ago. Mental illnesses behave in a similar way to physical illnesses. Some can be cured, others require lifelong therapy and some cannot be treated. Mental illness is more than ‘thinking that everything is black’. These are often extremely distressing conditions that are in no way different from serious physical illnesses. The case of Zoraya ter Beek is a good example. In contrast to other cases, it is incomprehensible why she had to go through such a long period of suffering until her case was finally assessed. ‘People think you can't think clearly when you're mentally ill, and that's an insult,’ Zoraya told the Guardian before her death.

There should be much better treatment for those with, say, mental illness before we get to the dignitas booth!

There isn't. And that's that.

 

[jfollows]

As @bleeder4 notes, personal experience may play a part. Although I wasn’t present, my cousin was essentially starved to death because of her suffering from Huntingdon’s disease, which both she and her brother had suffered from. I felt then, as now, that there should be a better way.

 

[midland1]

A very very slippery slope, there was lady on the radio this morning given 6 months left went to a deferent doctors she is still around 12 years later.

 

[DarloRich]

Mental illness is more than ‘thinking that everything is black’.

of course - but the point still stands. Should you be allowed to end your life because you are experiencing what could be a transitory moment of depression or doubt?

The case of Zoraya ter Beek is a good example. In contrast to other cases, it is incomprehensible why she had to go through such a long period of suffering until her case was finally assessed.

It is incomprehensible to me that a young, physically fit and physically healthy person was allowed to kill themselves. Outrageous frankly. She was 29 and had a whole life ahead. How do we know that some of the symptoms of her condition would not have changed over year? How do we know that something like having a family might have changed her world view? There was a chance ( small perhaps but a chance nonetheless) that she could have recovered or improved. Her condition was not terminal and was a condition that could have been managed through a "normal" life in the same way as many other people.

In saying this you should note that you know nothing of my personal history or experience in this area.

Also, I am not a religious person, I don't believe in god or heaven or hell. I believe we get one chance here and that chance shouldn't be thrown away or wasted and, imo, it was in this case. Badly so.

In saying that I acknowledge nothing untoward occurred, that all parties were of full capacity and actions were carried out in accordance with Dutch law.

‘People think you can't think clearly when you're mentally ill, and that's an insult,’

I would never say that. I simply say that I do not think mental illness should be grounds for assisted dying. I have no real problem with someone who is terminally ill being able to seek a form of assisted dying at a time of thier choice as long as they retain the competency to make that choice. I would say this should be available to any adult.

if not, then there would have to be a statement of some sort, made in front of a solicitor much like your will, setting out your view and your requirements when the time comes.

 

[bahnause]

It is incomprehensible to me that a young, physically fit and physically healthy person was allowed to kill themselves. Outrageous frankly. She was 29 and had a whole life ahead. How do we know that some of the symptoms of her condition would not have changed over year? How do we know that something like having a family might have changed her world view? There was a chance ( small perhaps but a chance nonetheless) that she could have recovered or improved. Her condition was not terminal and was a condition that could have been managed through a "normal" life in the same way as many other people.

The situation was assessed by numerous medical specialists. There was no realistic prospect of improvement. Of course, we can wait years for a miracle, but this also applies to numerous physical illnesses where recovery is not impossible. However, this does not justify years of suffering. And to be honest: her decision is not our business.

 

[GatwickDepress]

Seeing my father beg for death whilst suffering terminal throat cancer, in constant pain and unable to eat or even drink a teaspoon of water, I support this bill wholeheartedly. It was a relief that he passed in his sleep.

It left permanent scars on my family and I have nothing but the utmost respect for the hospice staff who care for terminal patients day in and day out. But, I feel it shouldn't have ever got to that point.

This is certainly a perception of mental illness from 50 years ago. Mental illnesses behave in a similar way to physical illnesses. Some can be cured, others require lifelong therapy and some cannot be treated. Mental illness is more than ‘thinking that everything is black’. These are often extremely distressing conditions that are in no way different from serious physical illnesses. The case of Zoraya ter Beek is a good example. In contrast to other cases, it is incomprehensible why she had to go through such a long period of suffering until her case was finally assessed. ‘People think you can't think clearly when you're mentally ill, and that's an insult,’ Zoraya told the Guardian before her death.

There isn't. And that's that.

As someone who has struggled with chronic mental health issues that have made life and daily functioning absolutely intolerable for over two decades, I would certainly go through the assisted dying process if it were an option here.

Of course, Britain's hostile environment and lack of any real support doesn't help matters, but they are conditions that see very little improvement from either medication or other therapeutic methods.

 

[Sorcerer]

I think this is something that should be left to medical professionals with some consultation with the patient. In the case of someone suffering from a medical condition with no reasonable prospect of recovery and with sufficient reason to believe it would drastically reduce the quality of life of the individual, then the individual in question should be allowed to decide, or failing that someone of sound mind that the patient has previously permitted to decide on their own behalf such as the next of kin, regardless of the patient's age. My dad was always adamant that if ever he got dementia we get him an assisted death, and honestly I'd want the same for myself.

For mental health issues such as depression the focus should mostly be on mental health treatment since they aren't of sound mind to be making such a decision. As someone who values life (a big part of why I'm against capital punishment) I would want to be sure that an individual is of sound mind and fully informed before deciding they want out, and mental health issues often cloud judgement of those suffering. Therefore I believe that qualified medical professionals consulting with the patient and/or next of kin should be the way to go about the subject of assisted dying.

 

[3141]

I’m 85 and I have advanced prostate cancer. It would probably have been curable if diagnosed earlier, but it wasn’t and it’s now controlled by two medications called Zoladex and Enzalutamide. These are both hormone treatments, not chemotherapy. The specialist told me that Enzalutamide remains effective for an average of five years. I’ve seen a somewhat different version which says that 50% of those taking it are still alive after five years. Either way, three years have now gone by. I’m hoping to be an above-average performer.

So far the medication has been very effective. I have a blood test every twelve weeks followed by a phone call from the specialist who tells me the results. He says he thinks I am doing very well. I can walk at least four miles (though I don’t do that regularly), and I can still do most of the things I’ve been accustomed to doing, though rather more slowly in some cases.

But this isn’t going to last forever. The possible side-effects of Enzalutamide include fatigue and reduced cognitive ability. I’ve experienced the former but not (so far) the latter. Of course it’s hard to tell if the fatigue is due to the medication, or the cancer, or these hormone treatments battling it out inside me, or a mixture of all these factors.

So at some stage the situation is going to change. The cancer will no longer be controlled as it is now. It may then spread elsewhere; it had already spread to my left thigh before it was diagnosed. Maybe there will be an alternative treatment, or maybe not. Perhaps the side-effects will become more pronounced. Perhaps the prognosis will be months rather than years. Perhaps I and other members of my family will become aware of declining mental facilities, which could arrive in any case as a separate issue.

I’d like then to have the option of bringing things to an end while I still have a degree of control over the situation. But there are certain problems (not an exhaustive list).

I think I’d find it difficult to take the final step until life had reached a considerable level of hardship. I hope I’d then still be capable of doing whatever was needed – if we’re talking about “assisted dying” and not expecting someone else to do it for us.

How do you tell your relatives? “Goodbye, I’m now off to do myself in.” Turning my wife into a widow would need thinking about. My granddaughters are now 16 and 13 and I think they could cope with the news, but there might be problems for younger children.

The position of doctors in all this needs thought about. It’s a serious business to decide whether or not a patient qualifies to be assisted to die. There may be pressure from the patient, or from some of the relatives, to reach a certain decision.

On balance I’m in favour of assisted dying. Introducing this is always going to be difficult and there are bound to be pluses and minuses whatever the conclusion of the debate.

 

[35B]

I'm opposed. There's a boundary that's already dangerously blurred with concepts like "double effect"; moving to allowing doctors to prescribe to kill cuts across a really important moral boundary.

I also accept that this is a matter where there can never be an adequate compromise, because there are compelling arguments for and against.

 

[Tazi Hupefi]

I'm opposed. There's a boundary that's already dangerously blurred with concepts like "double effect"; moving to allowing doctors to prescribe to kill cuts across a really important moral boundary.

I also accept that this is a matter where there can never be an adequate compromise, because there are compelling arguments for and against.

I have to say I can't fathom how anyone can be completely opposed to someone else making this decision about their own life. I can see how you'd be opposed to applying it to your own, but it seems cruel to deny someone the autonomy over their own decisions. In any event it's only autonomy to make a decision, not make that decision. Lots of people disregard medical advice all the time. Lots of prescriptions aren't collected or used. But lots of people will still want the ability to select what they feel is best for them, even if others think it's the objectively wrong decision.

I come from a fairly religious family, and suicide is against those beliefs, there are no religious exceptions in any denomination or interpretation of Islam, although I am not lost in the irony of fanatics and their terrorism methods. However, as far as I understand the teachings, there is nothing that compels me to intervene to prevent others from doing so or making that decision, so even if it might not be something I choose to do, I am perfectly satisfied that other people are able to make that decision. Suicide does, of course, happen in Islam, but it's often reframed so that it is not - using some very liberal interpretations, e.g. the illness caused the person to do XYZ, rather than the person did XYZ because of the illness.

 

[Buzby]

Seeing my father beg for death whilst suffering terminal throat cancer, in constant pain and unable to eat or even drink a teaspoon of water, I support this bill wholeheartedly. It was a relief that he passed in his sleep.

Couldn’t agree more. My wife of 40 years developed MND, and within 18 months declined to being fed by a tube and speaking through an iPad. The last 6 months I was begged (daily) to find some way of helping her end the suffering. I could never go through this again, and the fact ‘assisted dying’ has been a football that was kicked around by the government with no resolution as folk with no personal experience take what they believe to be some moral high ground and deny those suffering with terminal conditions any possibility of relief. MSP Margot McDonald tried (and failed) Scotland could have been groundbreaking but chickened out. If E&W changes the rules, I wonder how many milliseconds it will take before we ‘fall in line’?

 

[35B]

I have to say I can't fathom how anyone can be completely opposed to someone else making this decision about their own life. I can see how you'd be opposed to applying it to your own, but it seems cruel to deny someone the autonomy over their own decisions. In any event it's only autonomy to make a decision, not make that decision. Lots of people disregard medical advice all the time. Lots of prescriptions aren't collected or used. But lots of people will still want the ability to select what they feel is best for them, even if others think it's the objectively wrong decision.

I come from a fairly religious family, and suicide is against those beliefs, there are no religious exceptions in any denomination or interpretation of Islam, although I am not lost in the irony of fanatics and their terrorism methods. However, as far as I understand the teachings, there is nothing that compels me to intervene to prevent others from doing so or making that decision, so even if it might not be something I choose to do, I am perfectly satisfied that other people are able to make that decision. Suicide does, of course, happen in Islam, but it's often reframed so that it is not - using some very liberal interpretations, e.g. the illness caused the person to do XYZ, rather than the person did XYZ because of the illness.

Though I am of faith, my reasons for opposing this legislation are entirely secular*. The terms of the Bill, as they stand, are better than they might have been (self-administration stays the right side of a very important line), but they still shift the nature of the medical role so that it includes encompassing the death of a patient. That makes me profoundly uneasy.

It is not the choice to end life that I have a problem with here, but the involvement of a medical professional in that process. There's a profound taboo about doctors causing patients' death, and I believe it to be important and something that should not be undermined.

As a secondary matter, I also have issues with the framing of this as being about the choice to end one's own life. We all have rights that are qualified by our capacity as an individual; that of administering one's own death is but one of them. In reality, this is not the enabling of that right to those currently unable to take advantage of it, but the creation of a new right to die at a time of one's own choosing. People have been able to, and do, make that choice, but it is not a right.

* - There are plenty of matters that I might oppose on moral grounds associated with my faith but where the law has settled differently - divorce and abortion being two obvious examples. I do not regard faith as having veto power in this situation; the law permitting it does not oblige me to follow suit.

 

[Snow1964]

A very very slippery slope, there was lady on the radio this morning given 6 months left went to a deferent doctors she is still around 12 years later.

A rather weak argument, aim is not to end life the minute might have 6 months or less to live, but to allow a quicker end to distress, pain and suffering when get to the point where nothing can be done.

My own grandfather had an awful decline, spent the last 3 months of his life bedridden in hospital, he was distressed seeing how it upset family, and wanted us to remember him as he had been, not as a sad declining body laying in a hospital bed. In blunt terms all it achieved was lots of upset people, and one blocked hospital bed for 3 months that could have been helping those who were going to live to get better. So I am strongly for the assisted dying option.

 

[MP33]

My late Mother, whenever this subject came up. Used to ask the question. Where are they going to open the camp?

 

[david1212]

As proposed a first rung up the ladder but there are fundament shortcomings.
The first is that the person must be able to self-administer. This excludes someone paralysed from the neck down from e.g. a stroke or an accident.
The second is a life expectancy of no more than 6 months. Again taking someone paralysed from the neck down from e.g. a stroke or an accident they may feel they do not have a worthwhile quality of life but medically a life expectancy of several years.
My father had a first stroke which severely limited mobility then a second 6 months later totally paralysing his right side so needing constant care, two people to move him and soon bed sores. Also outwardly mental capacity/capability significantly reduced. If put in a chair/wheelchair or even propped up in bed he soon slumped so could only be for a short time. Hence his life was predominantly sleeping or staring at the ceiling. However it was 15 months after the second stroke before he died.

Whatever any other terms it is very debatable if he would have been judged as able to make a rational decision.
Given this I would like to see included being able while mentally healthy being able to define a set of conditions where if not met and recovery unlikely assisting dying would be invoked.
Not in constant / regular pain only suppressed by strong medication.
Able to get to and use the loo unassisted, even if from a wheelchair rather than walking.
Able by some means to communicate in a meaningful way.
Able to eat.
Able to read and turn pages of a book.
Able to read a computer screen and operate by some means to access websites, manage affairs etc.

 

[AlterEgo]

Extremely slippery slope given the two converging crises facing society - the problem of delayed or no inheritance thanks to extended lifespans and increasing care costs, and the burden of the elderly on the state health care bill and clogging up resources which may be otherwise directed towards younger people to have a better quality of life.

I would vote against it, as someone who has actually worked administering end of life care.

 

[dangie]

This is one of those arguments which I find myself agreeing (not disagreeing) with both sides. I appreciate that the bill has to go through Parliament, but to me it’s such a serious contentious issue that it shouldn’t be left to MP’s to decide on its fate (no pun intended). Should the public vote decide?

 

[Harpo]

Referenda with binary answers seem to fuel divisions rather than properly debate. Equally though, MPs who already have their minds made up totally fail their constituents.

 

[Senex]

Equally though, MPs who already have their minds made up totally fail their constituents.

Indeed. Allowing MPs a "free vote" is no guarantee that they will make any attempt to represent the views of their constituents rather than just voting in line with their own personal prejudices.

 

[ainsworth74]

Personally I'm broadly in favour of introducing this legislation. I find it intolerable that we allow suffering of human beings where this is no realistic hope of improvement or relief of that suffering before their likely death a short period of time later. This law appears to offer a way out of that position. I certainly have concerns. It seems to me that something has gone wrong with the way that similar laws have been implemented in Canada. Canada appears to have ended up in a situation in which chronic but not necessarily life ending conditions have come within scope. This clearly gives rise to arguments about people ending their life to avoid being a burden, something which doesn't apply in the same way, in my opinion, to someone with a terminal illness where death is expected within a short period of time. However, our proposed law is not the same as their law and I feel it strikes the correct balance between allowing someone the right to make decisions about their own life and bring it to an end in a controlled and humane way but not making it too easy to end their life.

The proposed law tightly restricts access and puts clear guard rails in place. By my understanding in order to be able to even begin to trigger this law a person must:

1) Have the capacity to make the decision themselves; and
2) Is aged 18 or over; and
3) Is ordinarily resident in England or Wales and has been so for at least 12 months; and
4) Is registered with a GP within England or Wales; and
5) Is terminally ill which is defined as being an inevitably progressive illness, disease or medical condition which cannot be reversed by treatment, and their death in consequence of that illness, disease or medical condition can reasonably be expected within 6 months.

An explicit carve out is made which explicitly says that someone cannot be terminally ill if their conditions are either a mental disorder (as defined by the Mental Health Act 1983) or a disability as defined within the Equality Act 2010.

Throughout the whole process at multiple different steps the person has to have a clear, settled and informed wish to end their own life, and has made the decision that they wish to end their own life voluntarily and has not been coerced or pressured by any other person into making it.

Presuming the above is true then that opens the door to an initial discussion with their medical practitioner (who is both under no obligation to suggest such a discussion on their own nor to enter into that discussion if they do not wish to) during which they must be told about their diagnosis and prognosis, any treatments available their likely effects as well as any available palliative, hospice or other care, including symptom management and psychological support.

Assuming that they wish to go ahead at that point they will need to make a first declaration in a prescribed format as laid down within the law which declares that they wish to have assistance to end their life, that they're eligible for that assistance, that they're not being coerced and it's voluntary, that they understand they'll need to be assessed and that they can change their mind at any time. This is witnessed by both their doctor and another person.

At that point the doctor then is required to carry out an assessment to satisfy themselves that the patient is terminally ill, has capacity to make the decision to end their own life, was aged 18 or over at the time the declaration was made, is ordinarily resident in England and Wales and has been so resident for at least 12 months, is registered as a patient with a GP practice in England or Wales, has a clear, settled and informed wish to end their own life, made the first declaration voluntarily and has not been coerced or pressured by any other person into making it. They then sign a declaration to that effect and refer it onto an other independent doctor who must also satisfy them as to the mentioned requirements but only after at least seven days have passed to allow the person to reflect. Both doctors are also required to consider medical records, speak to the person their diagnosis, prognosis, any treatments available their likely effects as well as any available palliative, hospice or other care, including symptom management and psychological support as well as the nature of the substance to be used to bring about their death and how it works.

Once all of that has been done and signed off an application must be made to the High Court for them to sign off and agree that all of the above has been done, that all the various factors that have been gone over by the medical professionals are satisfied (i.e. they're old enough, they're not being coerced, they're terminally ill, etc etc) and must, in person, question one or both of the doctors who have made their declarations. If the High Court sign off then a second fourteen day period of reflection comes into effect.

After those fourteen days then a second declaration can be made, again witnessed by the doctor and another person, that the individual wishes to end their life. The doctor has to again confirm that the person remains terminally ill, competent to make the decision, has a settled intent to end their life and is not being coerced. Then, finally, they can be provided with life ending substances (but the doctor cannot administer this, only provide it). Once they have died the doctor has to make a final statement basically confirming that the law has been followed, the various dates of the declarations and decisions and when it was administered. This is entered into the medical file.

It is a long process with multiple checks on the way to ensure that it is a process that is not abused. For instance if the second doctor refuses to certify, then you can go to one other doctor but if they also refuse you'd have to start again with a fresh declaration. And I reckon questions would be asked if you tried to do go again by the High Court if it got that far in the second attempt.

This is, in my opinion, a well considered law which will go a long way to relieving suffering that can be avoided whilst not creating a charter for people to either end their life because they feel like burden or being coerced into doing so for whatever reason by actors with ill intent. I hope it passes.

Should the public vote decide?

I'm not sure that Referendum's should ever be used on such complex matters. I increasingly take the view of my grandfather who was opposed to referendum's on the basis that we vote every four/five years for representatives to deal with these matters for us. Them kicking it back to the public via a referendum is a abrogation of their responsibility. I think there's a place for Citizens Assemblies to allow the legislature/politicians to get an understanding of what the public think and what choices/options they may have a preference for. But a straight up/down referendum on a subject like this is I think is a terrible idea as it is on basically any topic.

 

[3141]

Indeed. Allowing MPs a "free vote" is no guarantee that they will make any attempt to represent the views of their constituents rather than just voting in line with their own personal prejudices.

That raises another long-standing issue about whether an MP's role is to do what the majority of his/her constituents favour - if that can be established accurately - or to vote according to his/her conscience. But voting according to what an MP thinks is best or right is not just a matter of personal prejudice.

 

[Flange Squeal]

Seeing my father beg for death whilst suffering terminal throat cancer, in constant pain and unable to eat or even drink a teaspoon of water, I support this bill wholeheartedly. It was a relief that he passed in his sleep.

It left permanent scars on my family and I have nothing but the utmost respect for the hospice staff who care for terminal patients day in and day out. But, I feel it shouldn't have ever got to that point.

This post very much sums up my view as well. I also now have lasting memories of my own father wishing to die while suffering immense pain, when instead he could have been relieved of this and us as a family not had to witness someone we loved very dearly enduring that. I don't see how the prolonged suffering was beneficial for anyone.

 

[Barn]

Having had to spend 5 days last year going to hospital with my Mum to watch Dad slowly starve to death, I am fervently in favour of assisted dying. We were both practically on our knees begging the staff for him to be given a lethal injection, but the only option was just to give permission for them to stop intravenous injection of food and wait for nature to take its cause. 5 days he lasted and although he was sedated and unaware for the whole time, it was horrific for me and my Mum. We will both bear the emotional toll of that experience for the rest of our lives. If it was a pet it would have been put down in a heartbeat.

I'm extremely sorry for your loss, truly I am, but I think it's very dangerous to think of assisted death as a potential means to lessen the distress of the living.